LICENSING MATERIALS

ORDER FORM FOR STUDY GUIDES                                Date:                          

                                                                             Rec. #                                    

Name:                                                                                                      

Firm:                                                                                                        

Address:                                                                                                   

City/StateZip:                                                                                            

Phone #:                                                  

                                                   Study Guide Price      Qty.                     Total

State Code Book Only:

               Property/Casualty & Alaska Code                  $30.00                                                       

               Life/Health & Alaska Code                              $30.00                      _                               

Study Guides with Online Practice Testing Option:

               Property/Casualty with Online Practice Exam   $109.00                                                    

               includes P&C Alaska Law (Guide Only)

               Life/Health with Online Practice Exam               $109.00                                                    

               includes L&H Alaska Law (Guide Only)    
             

             Shipping & Handling Charge   ($10.00 per book)                                                      

           Total Amount Due/Enclosed       =                                    

We require payment by check or credit cards only. Checks should be made payable to AIIAB.

If you have any questions on the study guides, please call (907) 349-2500. 
 

Send payment and order form to:                        AIIAB

                                                                  701 W. 41st Ave., Suite 103

                                                                  Anchorage, AK  99503

Send Questions to:  AIIAB Office email:  akiiab@gci.net or call  (907) 349-2500.
Questions regarding Licensing Process should be directed to the State of Alaska, Division of Insurance
http://www.commerce.state.ak.us/insurance/Insurance/programs/Licensing/testingInfo.html

Or        Fax credit card information to AIIAB at 907-349-1300

            Circle One:   VISA    MC         

Card Number  _______________________________ 

Expiration Date ___________   CCV Code (3 digits on back of card)________

Name on Card_______________________________

Card Billing Address__________________________

Signature   __________________________________

Please follow up with a phone call to the AIIAB office to insure receipt of order. Or, print, scan and send to akiiab@gci.net for a faster response. Thanks!